Plant Comparison

Perforate St John’s-wort vs Elder

A side-by-side comparison of two medicinal plants — every documented constituent, action, use, safety note and cited source, assembled automatically from the Omnia Sana database.

First plant
Second plant
Show:
Plant APerforate St John’s-wortHypericum perforatumHypericaceaeFull monograph →
Plant BElderSambucus nigraAdoxaceaeFull monograph →

At a glance

Perforate St John’s-wort and Elder: they share 5 indicated uses (arthritis / joint pain, cold & flu, infection (general), …); 3 pharmacological actions in common.

Perforate St John’s-wortElder
Constituents33
Pharmacological actions63
Indicated uses96
Safety notes22
Cited sources3117
Indicated uses
Only Perforate St John’s-wort
BruisingEczemaInsomnia / sleeplessnessWounds
Shared (5)
Arthritis / joint painCold & fluInfection (general)Inflammation (general)Skin irritation
Only Elder
Respiratory support
Pharmacological actions
Only Perforate St John’s-wort
Emollient / skin-soothingSedative / sleep supportVulnerary (wound healing)
Shared (3)
Anti-inflammatoryAntioxidantAntiviral
Only Elder
none

Evidence face-off — shared uses

ConditionPerforate St John’s-wortElderVerdict
Arthritis / joint pain1/105/10Stronger for Elder
Cold & flu1/108/10Stronger for Elder
Infection (general)1/105/10Stronger for Elder
Inflammation (general)1/105/10Stronger for Elder
Skin irritation1/105/10Stronger for Elder

Evidence scores (1–10) are computed from the tier of each cited source. “Comparable” means the two scores are within one point. Follow a score to its detailed sources.

Key Constituents

Naphthodianthrones (hypericin, pseudohypericin)[4]

Red pigments historically used to standardise extracts; contribute to antiviral activity and are the compounds responsible for photosensitivity risk.

Phloroglucinols (hyperforin)[4]

Considered the principal compound behind the antidepressant activity and the main driver of the herb's potent CYP3A4/P-glycoprotein induction and drug-interaction profile.

Hyperforin
Flavonoids (hyperoside, quercetin, rutin)[4]

Antioxidant flavonoids contributing to overall activity.

FlavonoidsQuercetinRutin
Anthocyanins (cyanidin glycosides)[1]

Give the ripe berries their deep colour and much of their antioxidant activity.

Anthocyanins
Flavonoids (rutin, quercetin) and phenolic acids[1]

Found in both flower and berry, contributing antioxidant and anti-inflammatory activity.

FlavonoidsRutinQuercetinPhenolic acids
Cyanogenic glycosides (sambunigrin)[1]

Present in raw berries, leaves, bark and stems; the basis for the caution to always cook berries before eating and avoid raw plant material.

Glycosides

Pharmacological Actions

Anti-inflammatory[5, 15, 16]
Antioxidant[6, 15, 16]
Antiviral[15, 16]
Emollient / skin-soothing[15, 16]
Sedative / sleep support[1, 2, 4, 5, 9, 11, 12, 13, 14, 15, 16]
Vulnerary (wound healing)[4, 15, 16]
Anti-inflammatory[1, 5, 7, 11, 12, 13]
Antioxidant[1, 5, 6, 7, 9, 11, 12, 13]
Antiviral[1, 2, 4, 7, 11, 12, 13]

Traditional & Indicated Uses

Arthritis / joint pain[15, 16]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Arthritis / joint pain
Bruising[15, 16]Traditional · 1/10

inferred from vulnerary action

Evidence: 1
Label: Bruising
Cold & flu[15, 16]Traditional · 1/10

inferred from antiviral action

Evidence: 1
Label: Cold & flu
Eczema[15, 16]Traditional · 1/10

inferred from emollient action

Evidence: 1
Label: Eczema
Infection (general)[15, 16]Traditional · 1/10

inferred from antiviral action

Evidence: 1
Label: Infection (general)
Inflammation (general)[15, 16]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Inflammation (general)
Insomnia / sleeplessness[15, 16]Traditional · 1/10

inferred from sedative action

Evidence: 1
Label: Insomnia / sleeplessness
Skin irritation[15, 16]Traditional · 1/10

inferred from anti-inflammatory action

Evidence: 1
Label: Skin irritation
Wounds[15, 16]Traditional · 1/10

inferred from vulnerary action

Evidence: 1
Label: Wounds
Arthritis / joint pain[11, 12, 13]Moderate · 5/10

inferred from anti-inflammatory action

Evidence: 5
Label: Arthritis / joint pain
Cold & flu[2, 11, 12, 13]Good · 8/10

inferred from antiviral action

Evidence: 8
Label: Cold & flu
Infection (general)[9, 11, 12, 13]Moderate · 5/10

inferred from antiviral action

Evidence: 5
Label: Infection (general)
Inflammation (general)[5, 11, 12, 13]Moderate · 5/10

inferred from anti-inflammatory action

Evidence: 5
Label: Inflammation (general)
Respiratory support[2, 4, 11, 12, 13]Good · 8/10
Evidence: 8
Label: Respiratory support
Skin irritation[11, 12, 13]Moderate · 5/10

inferred from anti-inflammatory action

Evidence: 5
Label: Skin irritation

Safety, Cautions & Contraindications

Safety note[15, 16]Caution

Significant drug interactions: strongly induces CYP3A4 and P-glycoprotein, reducing plasma levels of many drugs including oral contraceptives, antiretrovirals, cyclosporine, warfarin, and digoxin. May cause photosensitivity (fair-skinned individuals). Do not combine with SSRIs, SNRIs, or MAOIs (serotonin syndrome risk). Avoid in bipolar disorder.

Safety note[15, 16, 17]Caution

Duke (2002) rates St. John's wort as ++ (raised from earlier editions) and notes antidepressant, antiviral, antibacterial, and wound-healing activities at experimental and clinical levels. Hypericin and hyperforin are identified as key active constituents. Clinical evidence (score 2) confirms antidepressant efficacy in mild-to-moderate depression, and WHO/Commission E provide approval for this indication. Dose: 300 mg standardized extract (0.3% hypericin, 3–5% hyperforin) three times daily. Duke emphasizes the critical drug interaction: St. John's wort is a potent CYP3A4 inducer and can significantly reduce blood levels of many medications including oral contraceptives, cyclosporine, antiretrovirals, and warfarin. Avoid combined use with SSRIs (serotonin syndrome risk) and pharmaceutical antidepressants (Duke, 2002).

Safety note[11, 12, 13]Caution

The dark blue or purple berries are mildly poisonous in their raw state, but are edible after cooking.https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-nccih-26https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-Fagan-2019-28 Components of the elderberry plant, including its fruit, contain diverse https://en.wikipedia.org/wiki/Phytochemical, such as https://en.wikipedia.org/wiki/Alkaloid, https://en.wikipedia.org/wiki/Lectin, and cyanogenic glycosides, which may be toxic if consumed raw.https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-drugs-8 Consumption of berries, leaves, bark or stems, if not properly prepared, may cause https://en.wikipedia.org/wiki/Nausea, vomiting, and severe https://en.wikipedia.org/wiki/Diarrhea.https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-nccih-26https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-drugs-8https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-msk-27 Elderberry plant constituents or products should not be consumed during pregnancy or by people with https://en.wikipedia.org/wiki/Allergy or https://en.wikipedia.org/wiki/Gastrointestinal_disease.https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-drugs-8https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-msk-27 Elderberry products may cause https://en.wikipedia.org/wiki/Adverse_effect when used with https://en.wikipedia.org/wiki/Prescription_drug.https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-drugs-8https://en.wikipedia.org/wiki/Sambucus_nigra#cite_note-msk-27

Safety note[11, 12, 13, 14]Caution

Duke (2002) rates elderflower and elderberry as +++ with clinical evidence (score 2) for bronchostimulant, diaphoretic, and secretagogue activities, consistent with Commission E approval. Clinical use for colds, bronchitis, and fever is well-supported. Dose: dried flower: 3–5 g as tea three times daily. Important safety consideration: raw elderberries and elder bark contain sambunigrin (cyanogenic glycoside) and lectins — always cook berries before consumption, and avoid bark preparations for medicinal use without expert guidance (Duke, 2002).

External Ids

Gbif: 3189486
Powo: urn:lsid:ipni.org:names:433719-1
Wikidata: Q158289
Gbif: 2888728
Wikidata: Q22701

Botanical Description

Erect, branching perennial herb with paired, oval leaves dotted with tiny translucent oil glands that look like pinpricks when held to the light (giving the species name 'perforatum'). Bright yellow, five-petalled flowers with numerous stamens and black dots along the petal edges are borne in flat-topped clusters, and release a reddish pigment when crushed.[4]

Height: 30-90 cm
Habit: Erect, branching perennial herb
Leaves: Paired, oval, dotted with tiny translucent oil glands
Flowers: Bright yellow, five-petalled, with numerous stamens and black-dotted petal edges, in flat-topped clusters
Stem: Erect, branching, with two raised longitudinal ridges
Root: Woody rootstock with spreading rhizomes
Fruit: Small, three-valved capsule
Flowering Period: June-September (traditionally around St John's Day, 24 June)

Deciduous shrub or small tree (Adoxaceae), 3-10 m tall (occasionally larger), with corky, furrowed grey-brown bark. Leaves are pinnate with 5-7 toothed leaflets. Abundant flat-topped clusters (corymbs) of small, fragrant, creamy-white flowers are followed by drooping clusters of small, glossy, purple-black berries.[11]

Height: 3-10 m (occasionally larger)
Habit: Deciduous shrub or small tree
Leaves: Pinnate, 5-7 toothed leaflets
Flowers: Small, fragrant, creamy-white, in flat-topped clusters (corymbs)
Stem: Corky, furrowed, grey-brown bark
Root: Fibrous, spreading root system
Fruit: Drooping clusters of small, glossy, purple-black berries
Flowering Period: May-June; berries ripen August-September

Habitat

Grows in grassland, roadsides, woodland clearings and waste ground on well-drained soils; native to Europe, Western Asia and North Africa and widely naturalised elsewhere, including North America and Australia.[4]

Native throughout Europe, western Asia and North Africa, extremely common in hedgerows, woodland edges, waste ground and disturbed sites, tolerating a wide range of soils.[11]

Harvesting

The flowering tops (flower and upper leaf) are cut in summer as the flowers open, around the traditional St John's Day period, and dried quickly in a warm, shaded, airy place to preserve the hypericin and hyperforin content.[4]

Parts: Flower, Leaf
Season: Summer, at flowering

Flowers are picked in full bloom (late spring/early summer), ideally on a dry day, and dried quickly. Berries are picked in late summer/early autumn once fully ripe (deep purple-black) and always cooked before use, as raw berries - and all other parts of the plant - contain cyanogenic glycosides and should not be eaten raw.[11]

Parts: Flower, Fruit
Season: Flower late spring/early summer; berries late summer/early autumn

Traditional Uses

St John's wort has a centuries-long European folk reputation as a wound-healing and nerve tonic herb, traditionally used for mild wounds, burns and nerve pain and to lift low mood; this traditional mood-supporting use is now one of the most extensively clinically studied applications of any herbal medicine, with standardised extracts shown comparable to conventional antidepressants for mild-to-moderate depression.[1, 4]

Elder has one of the most celebrated European folk-medicine reputations, described as a 'medicine chest' of the countryside. The flowers have official European herbal-monograph use for symptoms of the common cold, and the berries - cooked, or as a standardised extract - are widely used and clinically studied for upper respiratory and flu-like symptoms.[2, 11]

Preparations

Standardised extract[1]

Flowering-top extract standardised to hypericin and/or hyperforin content, taken as tablets or capsules; the best-studied clinical form for mood support.

Elderflower infusion (tea)[11]

Dried flower steeped in hot water - the classic cold and flu remedy.

Elderberry syrup[2]

Cooked, sweetened berry preparation - the most widely used commercial and traditional form for immune and cold support.

Standardised elderberry extract[2]

The concentrated form used in influenza clinical trials.

Dosage

Standardised extract[1]

Clinical trials for mild-to-moderate depression commonly use around 300 mg of standardised extract three times daily (900 mg/day total); given extensive drug interactions, use should be discussed with a healthcare provider, especially alongside other medicines. Educational reference only, not a prescription.

Dried flower (tea)[11, 12, 13]

Duke (2002): dried flower, about 3-5 g as tea, three times daily. Educational reference only, not a prescription; always cook berries before eating and avoid bark preparations without expert guidance.

Drug Class Interactions

Safety note[18, 19, 20, 21]Avoid
Drug Class: antidepressants-serotonergic
Mechanism: St John's wort raises serotonin activity; combined with SSRIs, SNRIs or MAOIs it can trigger serotonin syndrome (agitation, tremor, sweating, rapid heartbeat). Reviews of clinical reports document serotonin syndrome and lethargy when it is combined with serotonin-reuptake inhibitors.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 22]Avoid
Drug Class: antiretrovirals
Mechanism: Potent CYP3A4 and P-glycoprotein induction lowers antiretroviral levels (indinavir exposure fell ~57%), risking loss of viral control and drug resistance.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 23]Avoid
Drug Class: immunosuppressants
Mechanism: Enzyme and transporter induction reduces ciclosporin and tacrolimus levels; reported to cause subtherapeutic concentrations and transplant rejection.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 24, 25, 26]Avoid
Drug Class: hormonal-therapies
Mechanism: Increased metabolism of ethinylestradiol and progestins reduces contraceptive exposure, causing breakthrough bleeding, ovulation and unplanned pregnancy. Randomised and controlled trials in women confirmed more breakthrough bleeding, reduced progestin levels and evidence of ovulation when St John's wort was added to the pill.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 21]Caution
Drug Class: anticoagulants-antiplatelets
Mechanism: CYP induction increases warfarin clearance and can lower INR, reducing the anticoagulant effect; close monitoring is needed.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 27]Caution
Drug Class: cardiac-glycosides
Mechanism: P-glycoprotein induction lowers digoxin levels (AUC fell ~25% over ten days), which may reduce its effect.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 21]Caution
Drug Class: statins
Mechanism: CYP3A4 induction lowers levels of simvastatin and atorvastatin, potentially weakening their cholesterol-lowering effect.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[18, 19, 21]Caution
Drug Class: cyp3a4-substrates
Mechanism: As a broad CYP3A4 and P-glycoprotein inducer, St John's wort can lower levels of many medicines cleared by this pathway; check each medication individually.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03
Safety note[20, 28, 29]Avoid
Drug Class: chemotherapy-agents
Mechanism: St John's wort strongly induces CYP3A4 and P-glycoprotein, speeding the breakdown and removal of several cancer medicines. In patients it cut the active form of irinotecan (SN-38) by about 42% and reduced imatinib exposure by roughly a third - enough to weaken treatment and risk drug resistance. Do not take St John's wort during chemotherapy.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

Not documented

References

REF-0842, REF-0843, REF-0844, REF-1789, REF-1790, REF-1791, REF-1792, REF-1793, REF-1794, REF-1795, REF-1796, REF-1797, REF-1798, REF-1799
REF-1015, REF-1016, REF-1017, REF-1018, REF-1019, REF-1020, REF-1021, REF-1022, REF-1023, REF-1024

Pairings

St John's wort raises serotonin activity and can cause serotonin syndrome when combined with other serotonin-boosting agents; pairing it with another mood-active, serotonergic herb such as saffron may add to this risk.[30]

Partner Id: crocus-sativus
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

St John's wort is a strong enzyme inducer and increases serotonin activity; combining it with another antidepressant-type herb such as rhodiola may add to serotonergic effects and unpredictably change how each is handled by the body.[30]

Partner Id: rhodiola-rosea
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

St John's wort speeds up the breakdown of many substances and also raises serotonin activity; pairing it with a sedative herb such as valerian may add to drowsiness and can unpredictably change how each is handled by the body.[30, 31]

Partner Id: valeriana-officinalis
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

St John's wort is a strong enzyme inducer and kava is a liver-metabolised sedative; combining them may add to central-nervous-system effects and alter how kava is processed, so combined use warrants caution.[30, 31]

Partner Id: piper-methysticum
Type: caution
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-03

Not documented

Lookalikes Review

Outcome: none-known
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-07
Outcome: has-lookalikes
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-06

Dangerous Lookalikes

Not documented

Safety note[15, 16, 17]Dangerous
Dangerous Plant: sambucus-ebulus
Confused Part: Flower heads and ripe black berries, gathered mistaking them for elderflower or elderberry.
Confusion Context: Dwarf elder (danewort) is a close relative of elder with very similar flat-topped white flower clusters and small black berries, and the two grow in the same hedgerows and waste ground. But all parts of dwarf elder are toxic — it contains ebulin, a ricin-related toxin, plus cyanogenic compounds — and eating the flowers or berries causes severe nausea, vomiting and diarrhoea. (Even true elderberry must be cooked before eating.)
Distinguishing Features: Stem: elder is a woody shrub or small tree (up to several metres) with bark and woody stems that persist through winter; dwarf elder is herbaceous — soft green non-woody stems, no bark, about 1 to 2 m, dying back to the ground each year and re-sprouting in dense colonies. A woody, bark-covered stem means it is NOT dwarf elder., Anthers: dwarf-elder flowers have contrasting purple or dark-red anthers; elder flowers have cream-to-yellow anthers., Berries: elder's ripe berry clusters droop and hang down; dwarf elder holds its flower and fruit heads erect, facing upward.
Key Test: Check the stem: a hard, woody, bark-covered stem that persists year-round = elder (its cooked flowers and berries are a safe food). A soft, green, non-woody stem forming a dense colony that dies back each winter = dwarf elder — do not eat it. Purple anthers and upward-facing berry heads confirm dwarf elder.
Reviewed By: Omnia Sana (owner-authorized)
Reviewed Date: 2026-07-06

References & Sources

  1. Ng, Q.X., Venkatanarayanan, N. and Ho, C.Y.X (2017) 'Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis', Journal of Affective Disorders, 210, pp. 211-221. doi:10.1016/j.jad.2016.12.048 Meta-analysis / review
    https://doi.org/10.1016/j.jad.2016.12.048
  2. Kholghi, G., Arjmandi-Rad, S., Zarrindast, M.R. and Vaseghi, S (2022) 'St. John's wort (Hypericum perforatum) and depression: what happens to the neurotransmitter systems?', Naunyn-Schmiedeberg's Archives of Pharmacology, 395(6), pp. 629-642. doi:10.1007/s00210-022-02229-z Traditional / reference
    https://doi.org/10.1007/s00210-022-02229-z
  3. Fugh-Berman, A (2000) 'Herb-drug interactions', Lancet, 355(9198), pp. 134-138. doi:10.1016/S0140-6736(99)06457-0 Traditional / reference
    https://doi.org/10.1016/S0140-6736(99)06457-0
  4. Nobakht, S.Z., Akaberi, M., Mohammadpour, A.H., Tafazoli Moghadam, A. and Emami, S.A (2022) 'Hypericum perforatum: Traditional uses, clinical trials, and drug interactions', Iranian Journal of Basic Medical Sciences, 25(9), pp. 1045-1058. doi:10.22038/IJBMS.2022.65112.14338 Meta-analysis / review
    https://doi.org/10.22038/IJBMS.2022.65112.14338
  5. Jiang, Z., Wang, F., Zhao, Y., Lu, L., Jiang, X., Huang, T., Lin, Y., Guo, L., Weng, Z. and Liu, E (2024) 'Hypericum perforatum L. attenuates depression by regulating Akkermansia muciniphila, tryptophan metabolism and NFkB-NLRP2-Caspase1-IL1beta pathway', Phytomedicine, 132, pp. 155847. doi:10.1016/j.phymed.2024.155847 Preclinical
    https://doi.org/10.1016/j.phymed.2024.155847
  6. Oliveira, A.I., Pinho, C., Sarmento, B. and Dias, A.C.P (2016) 'Neuroprotective Activity of Hypericum perforatum and Its Major Components', Frontiers in Plant Science, 7, pp. 1004. doi:10.3389/fpls.2016.01004 Meta-analysis / review
    https://doi.org/10.3389/fpls.2016.01004
  7. Russo, E., Scicchitano, F., Whalley, B.J., Mazzitello, C., Ciriaco, M., Esposito, S., Patane, M., Upton, R., Pugliese, M., Chimirri, S., Mammi, M., Palleria, C. and De Sarro, G (2013) 'Hypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactions', Phytotherapy Research, 28(5), pp. 643-655. doi:10.1002/ptr.5050 Meta-analysis / review
    https://doi.org/10.1002/ptr.5050
  8. Saddiqe, Z., Naeem, I. and Maimoona, A (2010) 'A review of the antibacterial activity of Hypericum perforatum L', Journal of Ethnopharmacology, 131(3), pp. 511-521. doi:10.1016/j.jep.2010.07.034 Meta-analysis / review
    https://doi.org/10.1016/j.jep.2010.07.034
  9. Mennini, T. and Gobbi, M (2004) 'The antidepressant mechanism of Hypericum perforatum', Life Sciences, 75(9), pp. 1021-1027. doi:10.1016/j.lfs.2004.04.005 Meta-analysis / review
    https://doi.org/10.1016/j.lfs.2004.04.005
  10. Liu, Y., Jiang, Y., Huang, R., Yang, J., Xiao, B. and Dong, J (2013) 'Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety', Climacteric, 17(4), pp. 325-335. doi:10.3109/13697137.2013.861814 Meta-analysis / review
    https://doi.org/10.3109/13697137.2013.861814
  11. Wurglics, M. and Schubert-Zsilavecz, M (2006) 'Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients', Clinical Pharmacokinetics, 45(5), pp. 449-468. doi:10.2165/00003088-200645050-00002 Meta-analysis / review
    https://doi.org/10.2165/00003088-200645050-00002
  12. Kasper, S (2001) 'Hypericum perforatum - a review of clinical studies', Pharmacopsychiatry, 34(Suppl 1), pp. S51-S55. doi:10.1055/s-2001-15467 Meta-analysis / review
    https://doi.org/10.1055/s-2001-15467
  13. Nathan, P (1999) 'The experimental and clinical pharmacology of St John's Wort (Hypericum perforatum L.)', Molecular Psychiatry, 4(4), pp. 333-338. doi:10.1038/sj.mp.4000557 Meta-analysis / review
    https://doi.org/10.1038/sj.mp.4000557
  14. Verotta, L (2003) 'Hypericum perforatum, a source of neuroactive lead structures', Current Topics in Medicinal Chemistry, 3(2), pp. 187-201. doi:10.2174/1568026033392589 Meta-analysis / review
    https://doi.org/10.2174/1568026033392589
  15. Linde, K. et al (2008) 'St John'. Traditional / reference
    https://scholar.google.com/scholar?q=St%20John
  16. Natural Standard (2013) 'Hypericum perforatum (St'. Traditional / reference
    https://scholar.google.com/scholar?q=Hypericum%20perforatum%20%28St
  17. Duke, J.A (2002) 'Handbook of Medicinal Herbs, Second Edition'. Traditional / reference
    https://scholar.google.com/scholar?q=Handbook%20of%20Medicinal%20Herbs%2C%20Second%20Edition
  18. Zhou, S., Chan, E., Pan, S.Q., Huang, M. and Lee, E.J.D (2004) 'Pharmacokinetic interactions of drugs with St John's wort', Journal of Psychopharmacology, 18(2), pp. 262-276. doi:10.1177/0269881104042632 Meta-analysis / review
    https://doi.org/10.1177/0269881104042632
  19. Izzo, A.A. and Ernst, E (2009) 'Interactions between herbal medicines and prescribed drugs: an updated systematic review', Drugs, 69(13), pp. 1777-1798. doi:10.2165/11317010-000000000-00000 Meta-analysis / review
    https://doi.org/10.2165/11317010-000000000-00000
  20. Borrelli, F. and Izzo, A.A (2009) 'Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations', The AAPS Journal, 11(4), pp. 710-727. doi:10.1208/s12248-009-9146-8 Meta-analysis / review
    https://doi.org/10.1208/s12248-009-9146-8
  21. Nicolussi, S., Drewe, J., Butterweck, V. and Meyer zu Schwabedissen, H.E (2020) 'Clinical relevance of St. John's wort drug interactions revisited', British Journal of Pharmacology, 177(6), pp. 1212-1226. doi:10.1111/bph.14936 Meta-analysis / review
    https://doi.org/10.1111/bph.14936
  22. Piscitelli, S.C., Burstein, A.H., Chaitt, D., Alfaro, R.M. and Falloon, J (2000) 'Indinavir concentrations and St John's wort', Lancet, 355(9203), pp. 547-548. doi:10.1016/S0140-6736(99)05712-8 Clinical study
    https://doi.org/10.1016/S0140-6736(99)05712-8
  23. Barone, G.W., Gurley, B.J., Ketel, B.L., Lightfoot, M.L. and Abul-Ezz, S.R (2000) 'Drug interaction between St. John's wort and cyclosporine', Annals of Pharmacotherapy, 34(9), pp. 1013-1016. doi:10.1345/aph.10088 Clinical study
    https://doi.org/10.1345/aph.10088
  24. Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
    https://doi.org/10.1016/j.contraception.2004.11.004
  25. Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
    https://doi.org/10.1016/j.contraception.2004.11.004
  26. Pfrunder, A., Schiesser, M., Gerber, S., Haschke, M., Bitzer, J. and Drewe, J (2003) 'Interaction of St John's wort with low-dose oral contraceptive therapy: a randomized controlled trial', British Journal of Clinical Pharmacology, 56(6), pp. 683-690. doi:10.1046/j.1365-2125.2003.02005.x Randomized trial
    https://doi.org/10.1046/j.1365-2125.2003.02005.x
  27. Johne, A., Brockmoller, J., Bauer, S., Maurer, A., Langheinrich, M. and Roots, I (1999) 'Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum)', Clinical Pharmacology and Therapeutics, 66(4), pp. 338-345. doi:10.1053/cp.1999.v66.a101944 Clinical study
    https://doi.org/10.1053/cp.1999.v66.a101944
  28. Mathijssen, R.H.J., Verweij, J., de Bruijn, P., Loos, W.J. and Sparreboom, A (2002) 'Effects of St. John's wort on irinotecan metabolism', Journal of the National Cancer Institute, 94(16), pp. 1247-1249. doi:10.1093/jnci/94.16.1247 Randomized trial
    https://doi.org/10.1093/jnci/94.16.1247
  29. Smith, P., Bullock, J.M., Booker, B.M., Haas, C.E., Berenson, C.S. and Jusko, W.J (2004) 'The influence of St. John's wort on the pharmacokinetics and protein binding of imatinib mesylate', Pharmacotherapy, 24(11), pp. 1508-1514. doi:10.1592/phco.24.16.1508.50958 Clinical study
    https://doi.org/10.1592/phco.24.16.1508.50958
  30. Izzo, A.A (2004) 'Drug interactions with St. John's Wort (Hypericum perforatum): a review of the clinical evidence', International Journal of Clinical Pharmacology and Therapeutics, 42(3), pp. 139-148. doi:10.5414/cpp42139 Meta-analysis / review
    https://doi.org/10.5414/cpp42139
  31. Caus, M.N., Lupoae, M. and Chitescu, C.L (2026) 'Efficacy and Safety of Herbal Supplements with Anxiolytic, Antidepressant, and Sedative Action: A Review of Clinical Data and Toxicological Risks', Pharmaceuticals, 19(3), pp. 399. doi:10.3390/ph19030399 Meta-analysis / review
    https://doi.org/10.3390/ph19030399
  1. Liu, D., He, X.Q., Wu, D.T., Li, H.B. and others (2022) 'Elderberry (Sambucus nigra L.): Bioactive Compounds, Health Functions, and Applications', Journal of Agricultural and Food Chemistry, 70(14), pp. 4202-4220. doi:10.1021/acs.jafc.2c00010 Traditional / reference
    https://doi.org/10.1021/acs.jafc.2c00010
  2. Hawkins, J., Baker, C., Cherry, L. and Dunne, E (2018) 'Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials', Complementary Therapies in Medicine, 42, pp. 361-365. doi:10.1016/j.ctim.2018.12.004 Meta-analysis / review
    https://doi.org/10.1016/j.ctim.2018.12.004
  3. Uhl, K. and Mitchell, A.E (2024) 'Elderberry, an Ancient Remedy: A Comprehensive Study of the Bioactive Compounds in Three Sambucus nigra L. Subspecies', Annual Review of Food Science and Technology, 15(1), pp. 27-51. doi:10.1146/annurev-food-072023-034423 Traditional / reference
    https://doi.org/10.1146/annurev-food-072023-034423
  4. Asgary, S. and Pouramini, A (2022) 'The Pros and Cons of Using Elderberry (Sambucus nigra) for Prevention and Treatment of COVID-19', Advanced Biomedical Research, 11, pp. 96. doi:10.4103/abr.abr_146_21 Traditional / reference
    https://doi.org/10.4103/abr.abr_146_21
  5. Ferreira, S.S., Martins-Gomes, C., Nunes, F.M. and Silva, A.M (2022) 'Elderberry (Sambucus nigra L.) extracts promote anti-inflammatory and cellular antioxidant activity', Food Chemistry: X, 15, pp. 100437. doi:10.1016/j.fochx.2022.100437 Preclinical
    https://doi.org/10.1016/j.fochx.2022.100437
  6. Dominguez, R., Pateiro, M., Munekata, P.E.S., Santos Lopez, E.M. and others (2021) 'Potential Use of Elderberry (Sambucus nigra L.) as Natural Colorant and Antioxidant in the Food Industry. A Review', Foods, 10(11), pp. 2713. doi:10.3390/foods10112713 Traditional / reference
    https://doi.org/10.3390/foods10112713
  7. Sanlier, N., Ejder, Z.B. and Irmak, E (2024) 'Are the Effects of Bioactive Components on Human Health a Myth?: Black Elderberry (Sambucus nigra L.) from Exotic Fruits', Current Nutrition Reports, 13(4), pp. 815-827. doi:10.1007/s13668-024-00572-6 Traditional / reference
    https://doi.org/10.1007/s13668-024-00572-6
  8. Ulbricht, C., Basch, E., Cheung, L., Goldberg, H. and others (2014) 'An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration', Journal of Dietary Supplements, 11(1), pp. 80-120. doi:10.3109/19390211.2013.859852 Meta-analysis / review
    https://doi.org/10.3109/19390211.2013.859852
  9. Has, I.M., Teleky, B.E., Szabo, K., Simon, E. and others (2023) 'Bioactive Potential of Elderberry (Sambucus nigra L.): Antioxidant, Antimicrobial Activity, Bioaccessibility and Prebiotic Potential', Molecules, 28(7), pp. 3099. doi:10.3390/molecules28073099 Preclinical
    https://doi.org/10.3390/molecules28073099
  10. Kim, J., An, J., Song, Y., Jang, M. and others (2024) 'Effect of Elderberry (Sambucus nigra L.) Extract Intake on Normalizing Testosterone Concentration in Testosterone Deficiency Syndrome Rat Model Through Regulation of 17beta-HSD, 5alpha-Reductase, and CYP19A1 Expression', Nutrients, 16(23), pp. 4169. doi:10.3390/nu16234169 Preclinical
    https://doi.org/10.3390/nu16234169
  11. European Medicines Agency (2018) 'European Union herbal monograph on Sambucus nigra L., flos'. Traditional / reference
    https://scholar.google.com/scholar?q=European%20Union%20herbal%20monograph%20on%20Sambucus%20nigra%20L.%2C%20flos
  12. Royal Botanic Gardens, Kew (n.d.). Available at: https://powo.science.kew.org Traditional / reference
    https://powo.science.kew.org
  13. Zakay-Rones, Z., Thom, E., Wollan, T. and Wadstein, J (2004) 'Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections', 32(2), pp. 132--140. doi:10.1177/147323000403200205 Randomized trial
    https://doi.org/10.1177/147323000403200205
  14. Duke, J.A (2002) 'Handbook of Medicinal Herbs, Second Edition'. Traditional / reference
    https://scholar.google.com/scholar?q=Handbook%20of%20Medicinal%20Herbs%2C%20Second%20Edition
  15. Jimenez, P. and Gayoso, M. and Tejero, J. and Cabrero, P. and Cordoba-Diaz, D. and Basterrechea, J.E. and Girbes, T (2012) 'Toxicity in mice of lectin ebulin f present in dwarf elderberry (Sambucus ebulus L.)', Toxicon, 61, pp. 26-9. doi:10.1016/j.toxicon.2012.10.009 Preclinical
    https://doi.org/10.1016/j.toxicon.2012.10.009
  16. Botanical Society of Britain and Ireland (2023) 'Sambucus ebulus L., dwarf elder (Fermanagh species accounts)'. Available at: https://bsbi.org/in-your-area/local-botany/co-fermanagh/fermanagh-species-accounts/sambucus-ebulus-l Traditional / reference
    https://bsbi.org/in-your-area/local-botany/co-fermanagh/fermanagh-species-accounts/sambucus-ebulus-l
  17. Botanical-online (2024) 'Differences between elder and dwarf elder (Sambucus nigra vs Sambucus ebulus)'. Available at: https://www.botanical-online.com/en/botany/differences-sambucus-nigra-ebulus Traditional / reference
    https://www.botanical-online.com/en/botany/differences-sambucus-nigra-ebulus

Generated automatically from the Omnia Sana plant database and its cited sources. For educational purposes only — not medical advice. Always consult a qualified practitioner before using medicinal plants.